title: Prognostic significance of the estrogen-regulated protein, cathepsin D, in breast cancer. An immunohistochemical study.
abstract: Expression of the estrogen-regulated lysosomal protease, cathepsin D, was studied in a series of 94 breast cancers using an immunohistochemical technique. Granular staining of tumor cell cytoplasm was detected in 62 cases. Positive staining was associated with a significant increase in overall time to relapse and when survival was analyzed in terms of intensity of cathepsin D staining there was a significant trend for both increased time to relapse and increased length of survival. The presence of estrogen receptor was associated with positive cathepsin D immunostaining, and in the subgroup of estrogen receptor-positive tumors cathepsin D staining was associated with significantly prolonged survival; this was not the case for estrogen receptor-negative tumors. Positive cathepsin D immunostaining was associated with significant prognostic advantage in patients with confirmed lymph node metastasis but not in node-negative patients. It is suggested that cathepsin D expression reflects the functional integrity of the estrogen response pathway. Cathepsin D may prove a clinically useful adjunct to assessment of estrogen receptor status.
authors.affiliation: Department of Pathology, University of Newcastle-Upon Tyne, United Kingdom.
authors.forename: J A
authors.initials: JA
authors.lastname: Henry
authors.forename: A L
authors.initials: AL
authors.lastname: McCarthy
authors.forename: B
authors.initials: B
authors.lastname: Angus
authors.forename: B R
authors.initials: BR
authors.lastname: Westley
authors.forename: F E
authors.initials: FE
authors.lastname: May
authors.forename: S
authors.initials: S
authors.lastname: Nicholson
authors.forename: J
authors.initials: J
authors.lastname: Cairns
authors.forename: A L
authors.initials: AL
authors.lastname: Harris
authors.forename: C H
authors.initials: CH
authors.lastname: Horne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000201:enzymology* / Q000401:mortality; D002402:Cathepsin D / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis; D016019:Survival Analysis; D013629:Tamoxifen / Q000627:therapeutic use; D014407:Tumor Cells, Cultured
chemical_list: D011960:Receptors, Estrogen; D013629:Tamoxifen; D002402:Cathepsin D